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More than experience: a post-task reflection intervention among team members enhances performance in student teams confronted with a simulated resuscitation task—a prospective randomised trial
  1. Patrizia Kündig1,
  2. Franziska Tschan2,
  3. Norbert K Semmer3,
  4. Camille Morgenthaler2,
  5. Jasmin Zimmermann2,
  6. Eliane Holzer2,
  7. Simon Andreas Huber2,
  8. Sabina Hunziker4,
  9. Stephan Marsch5
  1. 1 Department of Anesthesiology, University Hospital of Bern, Inselspital, Bern, Switzerland
  2. 2 Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
  3. 3 Department of Psychology, University of Bern, Bern, Switzerland
  4. 4 Medical Communication and Psychosomatic Medicine, University Hospital of Basel, Basel, Switzerland
  5. 5 Medical Intensive Care, University Hospital of Basel, Basel, Switzerland
  1. Correspondence to Professor Franziska Tschan, Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel 2000, Switzerland; franziska.tschan{at}


Background Teams that regularly step back from action and deliberately reflect on their performance and strategies show higher performance. Ad hoc emergency teams with changing team composition cannot develop such habits but may engage in short postaction reflection to discuss shortcomings of past performance and potential adaptations of their strategies for future similar tasks. This study aimed to test the effect of a short postaction self-led reflective team briefing on resuscitation performance in a simulator setting in terms of three performance parameters: hands-on time, coordination between chest compression and ventilation, and defibrillation.

Methods We performed a randomised controlled trial including 56 ad hoc formed teams of three fourth-year medical students each. All groups performed a resuscitation task, followed by a self-guided reflective briefing, based on a general instruction (n=28 teams), or an unrelated discussion session (control condition; n=29), followed by a second resuscitation task in the same team composition.

Results Adjusted for performance in the first task, teams in the reflection condition showed higher performance gain in the second resuscitation than teams in the control condition (6.21 percentage points (95% CI 1.31 to 11.10, p<0.001)) for basic hands-on performance; 15.0 percentage points (95% CI 2 to 28, p<0.001) for coordinative performance but non-significantly lower performance for defibrillation (−9%, 95% CI −27% to –9%, p=0.312).

Conclusion Even very short self-led postaction reflective briefings enhance basic resuscitation performance in ad hoc groups but may not influence more complex aspects of the task. We recommend including short self-led team debriefings as part of simulator training.

  • teamwork performance
  • simulation for teamwork training
  • resuscitation
  • simulation-based training

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  • PK and FT contributed equally.

  • Contributors All authors approved the final version of the manuscript. The first two authors contributed equally to the manuscript. PK: conception, manuscript draft, data collection and coding. FT: conception, manuscript draft, manuscript revistion, development of coding and data analysis. NKS: conception and manuscript draft. CM: conception, manuscript draft, coding development, coding and data analysis. JZ and EH: manuscript revision, coding and data analysis. SAH: manuscript revision, coding development, coding and data analysis. SH: manuscript revision and coding development. SUM: conception, manuscript draft, manuscript revision and data collection.

  • Funding This work was supported by the Swiss National Science Foundation, grant #149734.

  • Competing interests None declared.

  • Ethics approval The study was approved by the local ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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